Staphylococcal scalded skin syndrome - Síndrome Estafilocócico De La Piel Escaldada
☆ En los resultados de 2022 del Stiftung Warentest de Alemania, la satisfacción del consumidor con ModelDerm fue sólo ligeramente inferior que con las consultas de telemedicina pagadas.
Un bebé con Síndrome Estafilocócico De La Piel Escaldada (Staphylococcal scalded skin syndrome)
References
Staphylococcal Scalded Skin Syndrome es una afección en la que la piel se muda debido a las toxinas producidas por ciertos tipos de bacterias estafilococos. Es poco común en niños mayores de seis años. También puede ocurrir en adultos con sistemas inmunológicos debilitados o problemas renales graves. La característica principal es una descamación extensa de la piel después de una inflamación. La gravedad varía desde unas pocas ampollas hasta una pérdida generalizada de piel, lo que puede provocar caídas graves de la temperatura corporal e inestabilidad de la presión arterial.
Staphylococcal Scalded Skin Syndrome is a disease characterized by denudation of the skin caused by exotoxin producing strains of the Staphylococcus species, typically from a distant site. It usually presents 48 hours after birth and is rare in children older than six years. It may also present in immunocompromised adults or those with severe renal disease. The disorder is characterized by significant exfoliation of skin following cellulitis. The severity may vary from a few blisters to system exfoliation leading to marked hypothermia and hemodynamic instability.
Staphylococcal Scalded Skin Syndrome is a disease characterized by denudation of the skin caused by exotoxin producing strains of the Staphylococcus species, typically from a distant site. It usually presents 48 hours after birth and is rare in children older than six years. It may also present in immunocompromised adults or those with severe renal disease. The disorder is characterized by significant exfoliation of skin following cellulitis. The severity may vary from a few blisters to system exfoliation leading to marked hypothermia and hemodynamic instability.
Staphylococcal scalded skin syndrome (SSSS) and bullous impetigo are infections caused by Staphylococcus aureus. Bullous impetigo is due to the local release of these toxins and thus, often presents with localized skin findings, whereas SSSS is from the systemic spread of these toxins, resulting in a more generalized rash and severe presentation. Both conditions are treated with antibiotics that target S. aureus. These conditions can sometimes be confused with other conditions that result in superficial blistering.
Un niño de 10 meses llegó con secreción nasal y no comía bien. Los médicos dijeron que era una infección de las vías respiratorias superiores. Dos días después, regresó porque no mejoraba y tenía nuevos problemas como cara hinchada y piel irritada alrededor de la boca. Durante los dos días siguientes, el niño empeoró. Sus brazos y piernas se hincharon y su piel empezó a desprenderse. De regreso al hospital, los médicos notaron una erupción roja en su cara y en los pliegues de su piel, que palidecía al tocarla. Le diagnosticaron staphylococcal scalded skin syndrome (SSSS) y le recetaron antibióticos por vía intravenosa.
A 10-month-old male presented with rhinorrhea and decreased oral intake and was diagnosed with an upper respiratory infection. Two days later, he returned to the clinic due to a lack of improvement and the onset of new symptoms, including facial edema and perioral skin irritation. That evening, he became febrile at 100.4 °F and went to the emergency department at the local children's hospital. No further workup was done and the parents were instructed to continue with the current treatment regimen. Over the next 48 hours, the patient's symptoms worsened with the new onset of bilateral extremity edema and desquamation. The patient was returned to the emergency department. A physical exam was notable for a blanching, desquamating, erythematous rash on the face and creases of the arms, legs, and groin. A positive Nikolsky sign was reported. A clinical diagnosis of staphylococcal scalded skin syndrome (SSSS) was made, and the patient was started on intravenous clindamycin. This case illustrates a severe presentation of SSSS in a pediatric patient, demonstrating the challenges it poses to diagnosis and treatment.
A 10-month-old male presented with rhinorrhea and decreased oral intake and was diagnosed with an upper respiratory infection. Two days later, he returned to the clinic due to a lack of improvement and the onset of new symptoms, including facial edema and perioral skin irritation. That evening, he became febrile at 100.4 °F and went to the emergency department at the local children's hospital. No further workup was done and the parents were instructed to continue with the current treatment regimen. Over the next 48 hours, the patient's symptoms worsened with the new onset of bilateral extremity edema and desquamation. The patient was returned to the emergency department. A physical exam was notable for a blanching, desquamating, erythematous rash on the face and creases of the arms, legs, and groin. A positive Nikolsky sign was reported. A clinical diagnosis of staphylococcal scalded skin syndrome (SSSS) was made, and the patient was started on intravenous clindamycin. This case illustrates a severe presentation of SSSS in a pediatric patient, demonstrating the challenges it poses to diagnosis and treatment.
Una niña de 2 años apareció con un sarpullido en todo el cuerpo que se había desarrollado durante 48 horas, tras las picaduras de insectos en la cara el día anterior. Durante el examen, tenía una erupción generalizada formada por pequeños bultos que se fusionaban y, al frotarla ligeramente, su piel mostraba signos del signo de Nikolsky. No había signos de que la erupción afectara sus membranas mucosas. Los análisis de sangre no mostraron ningún signo de infección.
A 2-year-old girl presented a generalised rash with 48 h of evolution, in the context of insect bites on the face on the day before. At observation, she had a generalised micropapular rash with confluent areas and Nikolsky sign. There was no mucosal area affected. Blood cultures were negative.
A 2-year-old girl presented a generalised rash with 48 h of evolution, in the context of insect bites on the face on the day before. At observation, she had a generalised micropapular rash with confluent areas and Nikolsky sign. There was no mucosal area affected. Blood cultures were negative.
El síndrome es inducido por exotoxinas epidermolíticas (exfoliatina) A y B, que son liberadas por S. aureus. El pronóstico del síndrome estafilocócico de la piel escaldada (staphylococcal scalded skin syndrome) en niños es excelente, con resolución completa dentro de los 10 días posteriores al tratamiento y sin cicatrices significativas. Sin embargo, el síndrome estafilocócico de la piel escaldada (staphylococcal scalded skin syndrome) debe diferenciarse cuidadosamente de la necrólisis epidérmica tóxica, que conlleva un mal pronóstico.
○ Diagnostico y tratamiento
El diagnóstico erróneo de lesiones de eccema, como la dermatitis atópica, y la aplicación de ungüentos con esteroides exacerban las lesiones. Busque atención médica lo antes posible mientras aplica un ungüento antibiótico.
#Bacitracin
#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)